Healthy diet for alpha-1 antitrypsin deficiency

Balanced diet for alpha-1 antitrypsin deficiency

For people with alpha-1 antitrypsin deficiency, a balanced diet is very important, as it is essential for healthy lung function. A healthy diet can positively influence lung function by improving muscle function and the impulses that activate breathing. It also strengthens the immune system.

Energy intake, and therefore kilocalorie (kcal) intake, is crucial for alpha-1 antitrypsin deficiency. An alpha-1 antitrypsin deficiency patient should aim for a normal weight. Ideally, their body mass index (BMI) – the ratio between body weight and height – should be between 18 and 25. BMI is calculated as follows: body weight in kilograms divided by height in meters squared.

Patients with alpha-1 antitrypsin deficiency have a higher energy requirement for respiratory function. This requirement is approximately 500 to 600 kcal daily. In addition to meeting their energy needs, it is also important to ensure an adequate intake of nutrients – especially the three main nutrients: protein, fat, and carbohydrates. Protein is a crucial building block for the human body. Alpha-1 antitrypsin deficiency patients have a higher protein requirement (for muscle building). The energy requirement of an alpha-1 antitrypsin deficiency patient is 1.5 g of protein per kg of body weight per day, which is approximately 20 percent of their total energy intake.

Animal and plant protein sources

Foods like meat, fish, eggs, and dairy products are animal protein sources. Legumes and soy, on the other hand, provide high-quality plant protein. Food combinations, such as potatoes with eggs or dairy products, or grains combined with eggs or dairy products, increase the protein quality. Since patients with alpha-1 antitrypsin deficiency are often unable to eat large meals, it is advisable to meet their calorie and nutrient needs through several small meals. A quark dish, yogurt, or a milkshake, for example, are healthy snacks. If needed, foods can also be enriched with protein powders. These can be stirred into soups or sauces, for instance.

Patients with alpha-1 antitrypsin deficiency can improve their respiratory function by paying attention to the respiratory quotient. This means consuming fewer carbohydrates and more healthy fats. Alpha-1 antitrypsin deficiency patients should only obtain 40 percent of their total energy from carbohydrates. Suitable sources include finely ground whole-grain products, two portions of fruit, and three portions of vegetables per day. A portion size should roughly fit in the palm of your hand. Sweets such as gummy bears, chocolate, cakes, pastries, or sugary drinks like cola and lemonade are permitted in small quantities.

Healthy fats with plenty of omega-3 fatty acids

The remaining 40 percent of total energy is available from fat, with a preference given to healthy fats rich in omega-3 fatty acids. These include, for example, olive, rapeseed, soybean, flaxseed, and walnut oil. Also recommended are fish such as salmon, herring, mackerel, tuna, and sardines, as well as nuts, such as walnuts, cashews, and macadamia nuts. Meat and sausage should be consumed in amounts no more than 300 to 600 grams per week. Fish should be on the menu twice a week. Three eggs per week are acceptable.

It is recommended to drink 1.5 to 2 liters of fluids per day, as excessive fluid intake can strain the lungs. Low phosphorus levels are harmful to the lungs. However, if the recommendations for meat/sausages, dairy products, whole grains, and nuts are followed, there is no risk.

Alpha-1 patients who are not taking immunosuppressants can strengthen their immune system by consuming fiber-rich and omega-3-rich foods, fermented dairy products, fresh herbs, spices, green tea or ginger tea, and by exercising.

Guest article by Annette Müller, dietician, nutrition specialist in allergology

What effect does an alpha-1 antitrypsin deficiency have on the liver, and what consequences does this have for your diet?

Alpha-1 antitrypsin is a protein produced in the liver that protects the body (especially the lungs) from endogenous enzymes that trigger inflammatory processes. Small changes in the structure of alpha-1 antitrypsin, such as those that occur in alpha-1 antitrypsin deficiency, prevent the release of alpha-1 antitrypsin from the liver into the bloodstream. This leads to an accumulation of the structurally altered alpha-1 antitrypsin in the liver, which can cause severe liver damage, potentially even cirrhosis or the formation of liver tumors. Liver diseases such as cirrhosis, liver failure, or liver cancer are the second leading cause of death in alpha-1 antitrypsin deficiency.

In cases of liver disease with an unclear cause, testing for alpha-1 antitrypsin deficiency should always be considered. This is especially important if the family history includes liver or lung disease, possibly even alpha-1 antitrypsin deficiency, if the patient is younger than 45 years old, is an active smoker, or is exposed to pollutants.

Individuals with alpha-1 antitrypsin deficiency are advised to participate in regular check-ups that can detect liver changes. Abnormal liver function tests, such as ALT, AST, Gamma GT, ALP, jaundice, and liver enlargement, require further investigation.

One healthy eating, A diet that strengthens the immune system and is rich in vitamins (vitamin A, vitamin D, vitamin C), avoiding being overweight or underweight, and consuming little or no alcohol are factors that should be implemented from a nutritional therapy perspective. Attention should be paid to the intake of magnesium (grains, nuts, and legumes), the trace elements zinc (fish, cheese, grains), selenium (fish, barley), and folic acid (liver, kidneys, peanuts, sunflower seeds). The German Nutrition Society (DGE) defines a healthy diet using 10 rules. The nutritional recommendations for patients with alpha-1 antitrypsin deficiency are also based on these 10 rules. However, compared to healthy individuals, patients with alpha-1 antitrypsin deficiency should consume more protein (specifically 20%), more healthy fats (40%), and fewer carbohydrates (30%) as part of their total energy needs.

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